Active NPI
Maria Suzanne Kaczmarek Baum, RN
- Family Nurse Practitioner
- Columbus, OH
National Provider Identifier
1104612571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209.033118
- Practice address
- 1577 Neil Ave
Columbus, OH 43201-2320 - Phone
- (563) 564-0418
- NPI assigned
- Apr 15, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.033118 | IL | Primary |
| Registered Nurse | 163W00000X | 041571182 | IL |
Addresses
Primary practice location
1577 Neil Ave
Columbus, OH 43201-2320
Mailing address
1577 Neil Ave
Columbus, OH 43210-1216
Other practice location 1
40 75th St
Willowbrook, IL 60527-2325
Phone (630) 581-6372
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 581-5372
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041571182 | IL | MD | Registered Nurse |
| 209.033118 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Express Care 2, Inc | Current | Accepting new patients | |
| Midwest Express Care 2, Inc | Single Specialty | Current | Accepting new patients |
Locations
40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Urgent Care Clinic/Center
- Willowbrook, IL
- NPI 1548692890
Single Specialty
-
- Urgent Care Clinic/Center
- Chicago, IL
- NPI 1659952554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756944000000",
"number": "1104612571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1577 NEIL AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432101216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1577 NEIL AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432012320",
"telephone_number": "563-564-0418"
}
],
"practiceLocations": [
{
"address_1": "40 75th St",
"address_purpose": "LOCATION",
"city": "Willowbrook",
"state": "IL",
"postal_code": "605272325",
"country_code": "US",
"telephone_number": "630-581-6372",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAUM",
"first_name": "MARIA",
"middle_name": "SUZANNE KACZMAREK",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-04-15",
"last_updated": "2025-09-04",
"certification_date": "2025-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209.033118",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041571182",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.